二维斑点追踪技术评估妊娠期甲状腺功能亢进患者胎儿的心功能

目的 探究二维斑点追踪技术评估妊娠期甲状腺功能亢进患者胎儿心功能。方法 选取2021年8月～2022年6月于我院就诊的妊娠期甲亢患者作为研究组（n=63），另选同期进行产前健康检查的孕妇作为对照组（n=55）。使用二维斑点追踪技术对两组患者胎儿的心功能进行检测，比较舒张末期的右心室面积（LVDA）、右心室周长（RVDC）、左心室周长（LVDC）及收缩末期的右心室面积（RVSA）、左心室面积（LVSA）、右心室周长（RVSC）、左心室周长（LVSC）；比较胎儿三尖瓣流速（TV）、二尖瓣流速（MV）、左右心室舒张早期与晚期血流速度（E峰值流速、A峰值流速）及其比值（E/A）、左心室收缩分数1(LVSF1)左心室收缩分数2(LVSF2)、右心室收缩分数1(RVSF1)、右心室收缩分数2(RVSF1)，比较胎儿心脏结构异常情况。结果 研究组患者胎儿收缩末期的LVSA、RVSA、RVSC、LVSC均高于对照组（P<0.05），而舒张末期的LVDA、RVDA、RVDC、LVDC均高于对照组（P<0.05）；研究组患者胎儿舒张期的心功能指标MVA、MVE、MV-E/A、TVA、TVE、T...

Assessment of fetal cardiac function in women with hyperthyroidism during pregnancy using two-dimensional speckle tracking imaging technique

  Objective  To explore the application of two-dimensional speckle tracking technique in assessing the fetal cardiac function in patients with thyroid dysfunction during pregnancy.  Methods  Sixty-three pregnant women with hyperthyroidism and another 55 healthy pregnant women underwent prenatal examination in our hospital from August 2021 to June 2022 were enrolled as study group and control group, respectively. Two-dimensional speckle tracking technology was used to detect fetal cardiac function. Comparison was conducted on parameters including right ventricular end-diastolic area (RVDA), left ventricular end-diastolic area (LVDA), right ventricular end-diastolic circumference (RVDC), left ventricular end-diastolic circumference (LVDC), right ventricular end-systolic area (RVSA), left ventricular end-systolic area (LVSA), right ventricular end-systolic circumference (RVSC), left ventricular end-systolic circumference (LVSC), tricuspid valve velocity (TV), mitral valve velocity (MV), peak E-wave velocity, peak A-wave velocity, E/A ratio, left ventricular shortening fraction 1 (LVSF1), left ventricular shortening fraction 2 (LVSF2), right ventricular systolic fraction 1 (RVSF1), right ventricular systolic fraction 2 (RVSF1). The fetal cardiac structures were observed, such as ventricular septal defect, tetralogy of Fallot, pulmonary stenosis, endocardial cushion defects, coarctation of aorta and tricuspid atresia.  Results  The differences of age, gestational weeks, BMI, systolic blood pressure, diastolic blood pressure and other clinical data between two groups were not significant (P > 0.05). LVSA, RVSA, RVSC and LVSC at end-systolic stage in study group were significantly higher than those in control group (P < 0.05), while LVDA, RVDA, RVDC and LVDC at end-diastolic stage were significantly higher than those in control group (P < 0.05). The fetal diastolic cardiac function indexes MVA, MVE, MV-E/A, TVA, TVE and TV-E/A in study group were significantly higher than those in control group (P < 0.05), and the end-systolic cardiac function indexes LVSF1, RVSF1, LVSF2 and RVSF2 were also higher than those in control group (P < 0.05). There were 9 cases (14.29%) of fetal cardiac structural abnormalities in study group, and the total incidence rate was significantly higher than that in control group (P < 0.05).  Conclusion  Fetal cardiac function is abnormal in patients with thyroid dysfunction during pregnancy, and cardiac structure may also be abnormal. Two- dimensional speckle tracking technology can accurately monitor fetal cardiac function and structure in the early stage.